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This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2001;155:757.
Maternal and Paternal Recreational Drug Use and Sudden Infant Death Syndrome
Although previous studies have reported an association between maternal
drug use and the risk of sudden infant death syndrome (SIDS), no studies have
investigated paternal substance use either during or after pregnancy. In this
case-control study of 239 infants who died of SIDS, Klonoff-Cohen and colleagues
found that maternal drug use during pregnancy was not associated with an increased
risk of SIDS. However, fathers' use of marijuana during conception and pregnancy
and postnatally was associated with a 2-fold increase in the risk of SIDS
in their infants. The role of paternal psychoactive drug use in SIDS is an
understudied area.
(SEE ARTICLE)
Efficacy of Naturopathic Extracts in the Management of Ear Pain Associated
With Acute Otitis Media
This Israeli study randomized children to receive either naturopathic
or anesthetic ear drops as the treatment for otitis media; none of the children
were given antibiotics. There was a significant improvement in ear pain during
the subsequent 48 hours in both groups. This study shows that withholding
antibiotics for some children with otitis media may be appropriate and feasible.
(SEE ARTICLE)
Do Hair Practices Affect the Acquisition of Tinea Capitis?
Although tinea capitis is a common infection in the United States, little
information is available on factors that may increase the risk of infection.
This case-control study from 3 US referral centers found that a history of
exposure to tinea capitis increased the risk of infection 16-fold, whereas
a history of tinea capitis in the child increased the risk 3-fold. Hair care
practices, including type of shampoo, hairstyle, and length of hair, were
not associated with risk of infection. This study supports the need to identify
and treat fungal carriers to decrease the risk of infection in the family.
(SEE ARTICLE)
Maternal Outcomes of a Randomized Controlled Trial of a Community-Based
Support Program for Families of Children With Chronic Illnesses
Previous studies indicate that mothers of children with chronic illness
are at risk for secondary mental health problems. During a 15-month period,
Ireys and colleagues conducted a randomized trial of a support program for
families with school-aged children with chronic illness. Linking these mothers
with other mothers of children with chronic illness significantly reduced
their anxiety and improved their mental health. This type of intervention
can and should be widely implemented.
(SEE ARTICLE)
The Behavioral Risks and Life Circumstances of Adolescent Mothers Involved
With Older Adult Partners
Adult men father more than 50% of all infants born to adolescent girls,
and more than 40% of these births involve fathers who are at least 5 years
older than their partners. In this study, 735 adolescent mothers with older
adult partners were interviewed 12 months after the birth of their child;
responses were compared with those of adolescents with similar-aged partners.
The study found that these mothers were less likely to be enrolled in school,
more likely to be trying to have another baby, and less likely to have a partner
willing to use a condom. These girls were also more socially isolated than
other adolescent mothers. The study indicates that societal tolerance of statutory
rape has important adverse consequences for teenaged mothers.
(SEE ARTICLE)
Parent Expectations for Antibiotics, Physician-Parent Communication,
and Satisfaction
Rising rates of resistant bacteria are causing increased attention to
the overprescription of antibiotics. Previous studies have suggested that
patient pressure is an important determinant of physician prescribing practices.
Mangione-Smith and colleagues audiotaped 287 encounters between physicians
and parents whose child had an upper respiratory tract infection. Although
50% of parents expected antibiotics, only 1% explicitly asked for them. Parents
not receiving antibiotics for their child were more satisfied if the physician
expressed a willingness to see the child again if no improvement occurred
within a couple of days. Such contingency plans may be successful in reducing
the inappropriate use of antibiotics.
(SEE ARTICLE)
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